Teaching Population Health: Innovations in the integration of the healthcare and public health systems

Population health is a critical concept in healthcare delivery today. Many healthcare administrators are struggling to adapt their organization from fee-for-service to value delivery. Payers and patients expect healthcare leaders to understand how to deliver care under this new model. Health administration programs play a critical role in training future leaders of healthcare organizations to be adaptable and effective in this dynamic environment. The purpose of this research was to: (a) engage current educators of health administration students in a dialogue about the best practices of integrating the healthcare and public health systems; (b) identify the content and pedagogy for population health in the undergraduate and graduate curricula; and (c) discuss exemplar population health curriculum models, available course materials, and curriculum integration options. Authors conducted focus groups of participants attending this educational session at the 2017 annual AUPHA meeting. Qualitative analysis of the focus group discussions was performed and themes identified by a consensus process. Study findings provide validated recommendations for population health in the health administration curriculum. The identification of key content areas and pedagogical approaches serves to inform health educators as they prepare future health administrators to practice in this new era of population health

Pedagogy: How to best teach population health to future healthcare leaders

Our healthcare system is moving from a fee-for-service reimbursement model to one that provides payment for improvements in three areas related to care: quality, coordination, and cost. Healthcare organizations must use a population health approach when delivering care under this new paradigm. Health administration programs play a critical role in training future leaders of healthcare organizations to be adaptable and effective in this dynamic environment. The purpose of this research was to: (1) engage health administration educators in a dialogue about population health and its relevance to healthcare administration education; (2) describe pedagogical methods appropriate for teaching population health skills and abilities needed for successful careers in our healthcare environment; and (3) identify current student learning outcomes that participants can tailor to utilize in their undergraduate and graduate health management courses. Authors conducted focus groups of participants attending this educational session at the 2018 annual AUPHA meeting. Qualitative analysis of the focus group discussions identified themes by a consensus process. Study findings provide validated recommendations for population health in the health administration curriculum. The identification of pedagogical approaches serves to inform educators as they prepare future health administrators to practice in this new era of healthcare delivery

Body of Knowledge for Health Administration Education: Teaching Epidemiology in the Age of Health Care Reform

As we embark on reforming the U.S. healthcare system, population-based healthcare is becoming even more important, and epidemiology is the basic science we will use to evaluate our effectiveness. Although recent research has shown that most undergraduate and graduate programs in health administration teach epidemiology courses in their curricula, the goals, objectives, and final content for such a course remain inconsistent across the programs. There are limited guiding principles (e.g., accreditation and certification criteria) on what health administration programs should expect of students studying epidemiology. To assess the similarities and differences in epidemiological content taught at the undergraduate and graduate levels, we systematically reviewed epidemiology content by querying those who teach this specific course via a national survey tool and syllabi obtained from programs. The purpose of this paper is to describe, for health administration programs, the (a) body of knowledge (i.e., content, principles) for a course in epidemiology taught at the undergraduate and graduate levels; and (b) perspectives of instructors regarding their approach in teaching epidemiology at the undergraduate or graduate level. This work will serve as a guide that can help educators when developing the competencies, goals, and objectives for epidemiology courses in their health administration programs

Determinants of Bacterial Contamination in Pools, Spas, and Wading Pools: Should Chlorine Standards Be Revised?

Using a retrospective case-control study, we compared poolside tests with bacteriological samples during three consecutive summers. A total of 844 matched samples were obtained. Increased chlorine levels were associated with lower rates of contamination. Alkalinity, pH, and TDS were not statistically associated with bacteriological failures. In swimming pools with \u3e 1 ppm of chlorine, 27/30 (90.0%) passed bacteriologic evaluation. In spas with \u3c 1.0 ppm of chlorine, only 12/28 (42.9%) passed. Of the spas with \u3e 3.0 ppm of chlorine, 170/176 (96.6%) passed. Of the wading pools with \u3c 1ppm of chlorine, only 12/25 (48.0%) passed. Of the wading pools with \u3e 2 ppm, 263/290 (90.7%) passed. Of available poolside tests, only chlorine levels are predictive of positive testing for fecal contamination. Higher levels of chlorine were associated with higher passing rates. Current standards for disinfection in spas and wading pools may need to be increased to help prevent contamination

Decreasing Clostridium Difficile Health Care - Associated Infections Through Use of a Launderable Mattress Cover

BACKGROUND: The annual incidence of Clostridium difficile infection (CDI) in the United States is estimated to be 330,000 cases. We evaluated the impact of using a launderable mattress and bed deck cover on the incidence of hospital-onset CDI in two long-term acute care hospitals (LTACH)s. METHODS: Two LTACH hospitals began using a launderable mattress and bed deck cover on beds starting in May of 2013. One facility had 74 beds and the other had 30 beds. Covers were changed after every patient. The covers were laundered using hot water, detergent, and chlorine. Rates for CDIs were compared using Poisson regression between the 16 months before use of the launderable cover and the 14 months after the cover started being used. RESULTS: At Hospital A, the use of bedcovers reduced the rate of infections by 47.8% (95% CI 47.1 – 48.6), controlling for the rate of hand washing compliance and length of stay in days. At Hospital B, the use of bedcovers reduced the rate of infections by 50% (95% CI 47.5 – 52.7), controlling for the rate of hand washing compliance and length of stay in days. CONCLUSIONS: The use of a launderable cover for mattresses and bed decks of hospital beds was associated with a decreased rate of healthcare associated CDIs in two LTACHs

Statewide cross-sectional survey of emergency departments\u27 adoption and implementation of the Ohio opioid prescribing guidelines and opioid prescribing practices

Study objective To evaluate the implementation of the Ohio Emergency and Acute Care Facility Opioids and Other Controlled Substances Prescribing Guidelines and their perceived impact on local policies and practice. Methods The study design was a cross-sectional survey of emergency department (ED) medical directors, or appropriate person identified by the hospital, perception of the impact of the Ohio ED Opioid Prescribing Guidelines on their departments practice. All hospitals with an ED in Ohio were contacted throughout October and November 2016. Distribution followed Dillman’s Tailored Design Method, augmented with telephone recruitment. Hospital chief executive officers were contacted when necessary to encourage ED participation. Descriptive statistics were used to assess the impact of opioid prescribing policies on prescribing practices. Results A 92% response rate was obtained (150/163 EDs). In total, 112 (75%) of the respondents stated that their ED has an opioid prescribing policy, is adopting one or is implementing prescribing guidelines without a specific policy. Of these 112 EDs, 81 (72%) based their policy on the Ohio ED Opioid Prescribing Guidelines. The majority of respondents strongly agreed/agreed that the prescribing guidelines have increased the use of the prescription drug monitoring programme (86%) and have reduced inappropriate opioid prescribing (71%). Conclusion This study showed that the Ohio ED Opioid Prescribing Guidelines have been widely disseminated and that the majority of EDs in Ohio are using them to develop local policies. The majority of respondents believed that the Ohio opioid prescribing guidelines reduced inappropriate opioid prescribing. However, prescribing practices still varied greatly between EDs

Teaching Population Health: Considerations for educating the future healthcare administration workforce

Managing population health is essential to the success of our reformed healthcare system since it allows for assessing the efficiency and effectiveness of healthcare delivery, and evaluating accountability, while striving to improve quality of care and reduce costs. The overarching goal of population health management is to keep patient populations healthy via preventive measures. Since healthcare organizations are unable to implement this approach alone, a collaborative approach is required. In response to this new approach to deliver and assess care, as educators we need to prepare future healthcare administrators at the undergraduate and graduate levels with the skills to be adaptable in this new era of healthcare. As we embark on delivering healthcare in a reformed system, population-based healthcare is becoming even more important and innovative teaching approaches are needed to provide a solid population health foundation for the healthcare management student today. The purpose of this paper is to describe the content, pedagogy, competency areas, and resources for teaching population health and its management in the undergraduate and graduate curricula

A randomized trial to evaluate a launderable bed protection system for hospital beds

Abstract Background Hospital beds are potential reservoirs of bacteria in hospitals. Preventing contamination of the bed and providing a cleaner surface should help prevent hospital-acquired infections (HAIs). Most hospital beds are cleaned between patients (terminal cleaning) using quaternary ammonia compounds (quats). Objective The study had two objectives: identify levels of bacterial contamination on beds (including the mattress and bed deck) and evaluate a new launderable cover. Methods Hospital beds on a bariatric surgery ward were randomized to either receive or not receive a launderable cover (Trinity Guardion, Batesville, IN). Bacterial counts on the surface of the mattress, the bed deck, and the launderable cover were then collected using Petrifilm™ Aerobic Count Plates (Petrifilm™, 3M™, St. Paul, MN, USA) (Petrifilm™) at three time periods (before patient use, after discharge, and after terminal cleaning). Standard hospital linen was used in all rooms. Results The launderable cover (n = 28) was significantly cleaner prior to patient use than were the cleaned mattresses (n = 38) (1.1 CFU/30 cm2 vs. 7.7 CFU/30 cm2; p = 0.0189). The mattresses without launderable covers became significantly contaminated during use (7.7 CFU/30 cm2 on admission vs. 79.1 CFU/30 cm2 after discharge; p 2 on admission vs. 2.5 CFU/30 cm2 at discharge; p = 0.703). After terminal cleaning, the mattress surface contamination decreased to 12.8 CFU/30 cm2 (median 3 CFU/30 cm2; SD 7.8), but the bed deck was more contaminated (6.7 CFU/30 cm2 after discharge compared to 30.9 CFU/30 cm2 after terminal cleaning; p = 0.031). Conclusions Terminal cleaning fails to eliminate bacteria from the surface of the hospital mattress. The launderable cover provides a cleaner surface than does terminal cleaning with quats, and the cover protects the bed from contamination during use.</p